摘要
[目的]探讨老年人拇趾外翻畸形围手术期处理的意义和诊治要点。[方法]自2000年1月．2006年12月实施老年人拇趾外翻矫形术45例，69足；病人年龄60—79岁，平均66．6岁，伴随疾病9种，共46个病变。手术前对伴随疾病作全面诊断，妥善治疗。根据拇趾外翻畸形程度、病人年龄及伴随症选择最佳麻醉和手术方式。术后注意预防各种并发症及实施适合老年人的康复治疗。[结果]本组45例，手术全部成功。围手术期伴随疾病无发作或加重，未出现全身及局部并发症。术后患足X线片，与术前比较：拇趾外翻角平均改善25°；第Ⅰ、Ⅱ跖骨间角平均改善7°。[结论]老年人拇趾外翻畸形保守治疗无效应当采取手术治疗，完善的围手术处理是手术成功和病人安全的保证。
[ Objective] To explore the significance and methods of the diagnosis and treatment in the geriatric patients with hallux valgus deformity during the perioperative period. [ Method ] Forty-five corrective operations （69 feet） were performed on hallux valgus deformity in geriatric patients between January 2000 and December 2006. The mean age of the patients were 66. 6 years （ ranging 60 - 79 years）. These 45 patients had other varying number of accompanying diseases, 9 different kinds in all which also added up to 46 in total number. Prior to the operations, comprehensive＇ diagnosis were made of the accompanying diseases which were also properly treated. The best anaesthesia and operative methods were chosen according to the extent of the deformities, age of the patients and their accompanying diseases. After the operation, attention should be paid to prevent various complications and appropriate post-operation rehabilitation treatments should be adopted for these geriatric patients. [ Result] All of the 45 cases were successful with no onset or aggravation of the accompanying diseases during the perio- perative period, nor did general or local complications appeared. Comparisons made between post and pre-operation X-ray plates of the troubled feet indicated that a mean 25 degree improvement were achieved for HVA and a mean 7 degree improvement for IMA. [ Conclusion] When conservative treatments of the hallux valgus deformity in the geriatric patient being proved ineffective, operative treatment should be suggested. Proper and meticulous perioperative management is the guarantee for the success of the operation and the safety of the patient.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2007年第21期1624-1627,共4页
Orthopedic Journal of China
关键词
拇趾外翻
畸形
老年病人
围手术期
hallux valgus
deformity
geriatric patient
perioperation period
